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Physical Therapy for Foot Pain & Plantar Fasciitis

  • Date : 2015-11-12
  • Thomas C. Weiss : Disabled World
  • Synopsis : Article examines physical therapy and other options for feet and heel pain, including Plantar fasciitis.

Main Document

In the physical therapy world, a person's walking pattern is a window into their condition, it provides physical therapists with insight concerning the person's current level of function and serves as a rather plain test to determine if treatments are being effective. Evaluating how a person walks is very valuable to the rehabilitation process. Often times, a person's walking pattern or, 'gait pattern,' dramatically improves due to the treatments received from just one physical therapy session. Karen McCain, a physical therapist, describes walking speed as the, 'sixth vital sign.'


Orthotics is defined as a specialty within the medical field concerned with the design, manufacture and application of orthoses. An Orthotic is a support, brace, or splint used to support, align, prevent, or correct the function of movable parts of the body. Shoe inserts are a type of orthotic intended to correct an abnormal or irregular walking pattern. Other orthotics include neck braces, lumbosacral supports, knee braces, and wrist supports.

In her article on the subject Karen stated, "It is important because walking speed depends on many factors, such as motor control, muscle strength, sensation, cognition, motivation, and overall health status."

Along with these essential elements of treating people, therapists also pay very close attention to the position of the person's foot and ankle as they walk. Pronation and supination are two very common foot and ankle conditions treated through physical therapy, which may lead to:

  • Hip pain
  • Heel pain
  • Joint pain
  • Knee pain
  • Nerve pain
  • Tendon pain

Heel Pain and Plantar Fasciitis

Painful heels are the number four concern that brings people into the offices of a number of family doctors, as well as the number one concern bringing people to the offices of podiatric physicians. Heel pain may have a number of causes, yet the vast majority is caused by plantar fasciitis. 'Plantar,' means, 'bottom of the foot.' 'Fascia,' is a ligament or bundle of ligaments. The plantar fascia is the thick ligament that helps a person to hold up their foot and provides, 'spring,' to the person's step.

Plantar fasciitis involves an inflammation of the plantar fascia and causes more than 90% of heel pain among adults in America. The condition may be acute but is often chronic, remaining for months if not years. The reason this occurs is due to poor foot mechanics, the person's foot sinking down too far to allow the plantar fascia to overstretch with every step the person takes. If the person's plantar fasciitis is acute then it is basically treated as a sprain with:

  • Ice
  • Rest
  • Physical therapy
  • Anti-inflammatory drugs

If the person's plantar fasciitis is chronic, their poor foot mechanics need to be approached. Foot mechanics are changed by use of molded shoe inserts known as, 'orthotics.' An individual with plantar fasciitis needs an orthotic designed to relieve strain on their plantar fascia. Orthotics are often times confused with arch supports. Arch supports, by holding up the person's arch, may remove some of the tension from their plantar fascia. Orthotics; on the other hand, do the majority of their work on the heel and ball of the foot, repositioning the person's foot for maximized function.

Before You See a Foot Doctor

One of the first things a person with foot issues visits a doctor, there are some things to try. The first of these is attempting to perform your own version of deep tissue massage by rolling a frozen bottle of water from the heel forward into the arch of the foot; gently. Do stretching, but the key to good stretching is not to stretch too hard. Generally avoid weight bearing or standing stretches, but sit on a soft surface such as your bed and pull your foot backward on your leg as far as it will go, holding for twenty seconds and relaxing for five seconds. Each set can be repeated five times - meanwhile, you have invested around two minutes and given yourself much help.

Your Feet, Shoes, Orthotics and ESWT

Be aware of the shoes you wear on your feet. It is tempting to obtain shoes that are not only colorful, but soft. Soft shoes are not a good thing, wrap a pillow around your foot with duct tape and walk for a block or so. You will come back with your foot hurting more because your foot sand deeper into the soft surface, permitting your tendons to stretch more. The shoes you wear should be stiff in the shank and flexible in the ball. Shoes such as these are known as, 'motion control shoes,' or, 'stability shoes,' and there are various shoe stores who sell them.

Orthotics, through treatment of the cause of the issue, lead to the cure more than 90% of the time. A small number of people have waited so long that their plantar fascia has become thickened and filled with scar tissue and are not helped by conventional means. These are the people who have traditionally needed surgical treatment in which the plantar fascia is cut off the person's heel bone. The majority of surgeries have been replaced by a fairly new mode of treatment called, 'Extracorporeal Shockwave Therapy (ESWT).' ESWT involves the application of multiple shock-waves to the person's tendon or ligament and has a success rate of between 85-90%. Bear in mind the people who receive treatment are from a population of, 'tough cases,' who have already received conventional treatment.

ESWT machines look like miniature renal lithtripsors or, 'kidney stone crushers.' There are almost no side-effects to ESWT other than the price - only around 30% of insurance companies will cover it. Insurance companies realize it is less costly and safer than surgery, yet also know that many more people who would avoid surgery would also have no problem with receiving ESWT so the volume of services would increase.

Facts: Plantar fasciitis

Plantar Fasciitis Foot ImagePlantar fasciitis (also known as plantar fasciopathy or jogger's heel) is a common painful disorder affecting the heel and underside of the foot. It is a disorder of the insertion site of ligament on the bone and is characterized by scarring, inflammation, or structural breakdown of the foot's plantar fascia.

Plantar Fasciitis is often caused by overuse injury of the plantar fascia, increases in exercise, weight, or age. The plantar fascia is the thick tissue on the bottom of the foot. It connects the heel bone to the toes and creates the arch of the foot. When this tissue becomes swollen or inflamed, it is called plantar fasciitis.

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